Sublime MD, a Professional Medical Corporation

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SUBLIME MD, A PROFESSIONAL MEDICAL CORPORATION

Doing business as

Sublime MD

Practice address

255 Terracina Blvd Ste 206
Redlands, CA 92373-4870

Phone

(909) 792-8600

NPI assigned

Nov 5, 2021

Last updated

Jan 27, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ronnie Nathan Dawood, MDNPI 1851593065

Title

President

Phone

(949) 367-1115

Specialties & licenses 7

Addresses

Other names 1

• Sublime MD Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Fred F. Soeprono, M.D., Inc.

  dba Advanced Dermatology and Laser Center

  • Dermatology Physician
  • Redlands, CA
  • NPI 1346441276

  Member Of

  NPD member

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ronnie Nathan Dawood, M.D.

  • Internal Medicine Physician
  • Mission Viejo, CA
  • NPI 1851593065

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Erika Lee Amthor, PA-C

  • Medical Physician Assistant
  • Murrieta, CA
  • NPI 1962808477
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1396400230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7095 INDIANA AVE STE 210",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064159",
            "telephone_number": "951-218-9910",
            "fax_number": "888-561-4883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 TERRACINA BLVD STE 206",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734870",
            "telephone_number": "909-792-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26342 Oso Pkwy Ste 204",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926915649",
            "country_code": "US",
            "telephone_number": "951-222-2212",
            "fax_number": "888-561-4883",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7095 Indiana Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925064159",
            "country_code": "US",
            "telephone_number": "951-218-9910",
            "fax_number": "888-561-4883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUBLIME MD, A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-05",
        "last_updated": "2022-01-27",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "DAWOOD",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_middle_name": "NATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-367-1115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sublime MD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sublime MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Leigh Straw
• Stretchx LLC
• Sharon R Strum, MD
• Student
• Glen Stute, COTA
• Jane Suh, M.S., CF-SLP
• Julia Eunahn Suh
• Rey Lance Sumulong, CRNA
• Sun Medical Equipment Inc (Sun Medical Supplies)
• Sun Medical Equipment Inc (Sun Medical Supplies)

• Dermatology Physician in Redlands, CA
• Providers in Redlands, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.